Background There is evidence in the literature that the use of sensor-augmented insulin pumps in patients with type 1 diabetes improves metabolic control. However, there is no long-term information on clinical outcomes such as hospitalization or admission to the emergency room. Our paper describes the outcomes of metabolic control, incidence of hospitalizations and emergency room visits in a Colombian population using this technology. Methods A retrospective cohort study was carried out in patients with diabetes being treated with an intensive insulin regimen at a specialized diabetes treatment center in Bogotá, Colombia, who required sensor-augmented insulin pumps due to poor metabolic control. Glycated hemoglobin, severe hypoglycemic episodes, non-severe hypoglycemic episodes, perception of hypoglycemia, and the incidence of emergency room visits and hospitalizations before and after treatment were evaluated. Results Sixty-four patients with a median age of 36 years (interquartile range 2746) were included in the study. We found better long-term management in terms of glycated hemoglobin (8.35% vs. 7%), non-severe hypoglycemic episodes (95.9% vs. 87.7%), emergency room visits (57.5% to 6.45%) and hospitalization (50% vs. 13.79%). Conclusions The use of sensor-augmented insulin pumps coupled with a strict follow up program for patients with type 1 diabetes leads to a significant and sustained reduction in glycated hemoglobin and hypoglycemic episodes, as well as in the rate of emergency room visits and hospitalizations. These results incentivize the adoption of this technology in patients who do not achieve metabolic control with optimal management of type 1 diabetes.
Background: There is evidence in the literature that the use of sensor-augmented insulin pumps in patients with type 1 diabetes improves metabolic control. However, there is no long-term information on clinical outcomes such as hospitalization or admission to the emergency room. Our paper describes the outcomes of metabolic control, incidence of hospitalizations and emergency room visits in a Colombian population using this technology. Methods: A retrospective cohort study was carried out in patients with diabetes previously treated with an intensive insulin regimen at a specialized diabetes treatment center in Bogotá, Colombia, who required sensor-augmented insulin pumps due to poor metabolic control despite optimization of medical management. Glycated hemoglobin, severe hypoglycemic episodes, non-severe hypoglycemic episodes, perception of hypoglycemia, and the incidence of emergency room visits and hospitalizations before and after treatment were evaluated. Results: Sixty-four patients with a median age of 36 years (interquartile range 27-46) were included in the study. We found statistical reduction of glycated hemoglobin (8.35% vs. 7%), non-severe hypoglycemic episodes (95.9% vs. 87.7%), emergency room visits (57.5%to 6.45%) and hospitalization (50% vs. 13.79%) in patients using CSII. Conclusions: The use of sensor-augmented insulin pumps coupled with a strict follow-up program for patients with type 1 diabetes leads to a significant and sustained reduction in glycated hemoglobin and hypoglycemic episodes, as well as in the rate of emergency room visits and hospitalizations. These results encourage the adoption of this technology in patients who do not achieve metabolic control with optimal management of type 1 diabetes.
BACKGROUND There is evidence in the literature that the use of sensor-augmented insulin pumps in patients with high complexity diabetes improves metabolic control. However, there is no long-term information on clinical outcomes such as hospitalization or admission to the emergency room. This study describes the outcomes of metabolic control, incidence of hospitalizations and emergency room visits in a specific population using this technology. OBJECTIVE We aimed to assess the long-term glycemic and clinical outcomes after the use of continuous subcutaneous insulin infusion and continuous glucose monitoring in people with diabetes. METHODS A retrospective cohort study was carried out in patients with diabetes previously treated with an intensive insulin regimen at a specialized diabetes treatment center, who required a sensor-augmented insulin pump due to non-optimal glycemic control. Glycated hemoglobin, severe hypoglycemic episodes, non-severe hypoglycemic episodes, perception of hypoglycemia, and the incidence of emergency room visits and hospitalizations before and after treatment were evaluated. RESULTS Between January 2013 and August 2020, 74 patients with a median age of 36 years (interquartile range 27–46 years) were included in the study with a median 4-year follow-up (interquartile range 2–7 years). We found a statistically significant reduction in glycated hemoglobin (8.35% vs. 7%; P<.001), non-severe hypoglycemic episodes (95.9% vs. 83.7%; P=.014 ), emergency room visits (57.5% to 6.45%; P<.001) and hospitalization (50% vs. 13.8%; P<.001) after use of a continuous subcutaneous insulin infusion. CONCLUSIONS The use of a sensor-augmented insulin pump associated with a strict follow-up program for patients with high complexity diabetes led to a significant and sustained reduction in glycated hemoglobin and hypoglycemic episodes, as well as in the rate of emergency room visits and hospitalizations. These results encourage the adoption of this technology in patients who do not achieve metabolic control with optimal management of diabetes. INTERNATIONAL REGISTERED REPORT RR2-10.21203/rs.3.rs-1688540/v2
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